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Trauma disparities

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https://www.readbyqxmd.com/read/28069138/disparities-in-access-to-trauma-care-in-the-united-states-a-population-based-analysis
#1
Brendan G Carr, Ariel J Bowman, Catherine S Wolff, Michael T Mullen, Daniel N Holena, Charles C Branas, Douglas J Wiebe
BACKGROUND: Injury is a major contributor to morbidity and mortality in the United States. Accordingly, expanding access to trauma care is a Healthy People priority. The extent to which disparities in access to trauma care exist in the US is unknown. Our objective was to describe geographic, demographic, and socioeconomic disparities in access to trauma care in the United States. METHODS: Cross-sectional study of the US population in 2010 using small units of geographic analysis and validated estimates of population access to a Level I or II trauma center within 60minutes via ambulance or helicopter...
January 3, 2017: Injury
https://www.readbyqxmd.com/read/28055823/mental-health-in-2020-for-men-who-have-sex-with-men-in-the-united-states
#2
Abigail W Batchelder, Steven Safren, Avery D Mitchell, Ivan Ivardic, Conall O'Cleirigh
Despite continued advances in HIV prevention and treatment, gay and bisexual men and other men who have sex with men (MSM) remain the population most impacted by HIV/AIDS in the US and many other Western countries. Additionally, MSM are disproportionately affected by various psychological problems, including depression, distress, trauma and substance use. These challenges frequently co-occur, and are associated with higher rates of behaviours related to HIV acquisition and transmission, HIV infection, and, for those living with HIV/AIDS, lower levels of treatment engagement...
January 6, 2017: Sexual Health
https://www.readbyqxmd.com/read/27992953/age-related-disparities-in-trauma-center-access-for-severe-head-injuries-following-the-release-of-the-updated-field-triage-guidelines
#3
Thomas J Flottemesch, Susan Raetzman, Kevin C Heslin, Katie Fingar, Rosanna Coffey, Marguerite Barrett, Ernest Moy
OBJECTIVE: In 2006, the American College of Surgeons' Committee on Trauma and the Center for Disease Control released field triage guidelines with special consideration for older adults. Additional considerations for direct transport to a Level I or II trauma center (TC) were added in 2011, reflecting perceived undertriage to TCs for older adults. We examined whether age-based disparities in TC care for severe head injury decreased following introduction of the 2011 revisions. METHODS: A pre-post design analyzing the 2009 and 2012 Healthcare Cost and Utilization Project State Emergency Department Databases (SEDD) and State Inpatient Databases (SID) with multivariable logistic regressions considered changes in (1) the trauma designation of the emergency department where treatment was initiated and (2) transfer to a TC following initial treatment at a non-TC...
December 19, 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/27986236/surgical-management-and-reconstruction-training-smart-course-for-international-orthopedic-surgeons
#4
Hao-Hua Wu, Kushal R Patel, Amber M Caldwell, R Richard Coughlin, Scott L Hansen, Joseph N Carey
BACKGROUND: The burden of complex orthopedic trauma in low- and middle-income countries (LMICs) is exacerbated by soft-tissue injuries, which can often lead to amputations. This study's purpose was to create and evaluate the Surgical Management and Reconstruction Training (SMART) course to help orthopedic surgeons from LMICs manage soft-tissue defects and reduce the rate of amputations. METHODS: In this prospective observational study, orthopedic surgeons from LMICs were recruited to attend a 2-day SMART course taught by plastic surgery faculty in San Francisco...
July 2016: Annals of Global Health
https://www.readbyqxmd.com/read/27966785/american-indian-and-alaska-native-boys-early-childhood-risk-and-resilience-amidst-context-and-culture
#5
Michelle Sarche, Greg Tafoya, Calvin D Croy, Kyle Hill
American Indian and Alaska Native (AIAN) adolescent and adult men experience a range of health disparities relative to their non-AIAN counterparts and AIAN women. Given the relatively limited literature on early development in tribal contexts, however, indicators of risk during early childhood specific to AIAN boys are not well-known. The current article reviews sources of strength and challenge within AIAN communities for AIAN children in general, including cultural beliefs and practices that support development, and contextual challenges related to socioeconomic and health disparities and historical trauma affecting the AIAN population as a whole...
January 2017: Infant Mental Health Journal
https://www.readbyqxmd.com/read/27939128/variations-in-utilization-of-inpatient-rehabilitation-services-among-pediatric-trauma-patients
#6
Huong T Nguyen, Christopher Newton, Elizabeth A Pirrotta, Christine Aguilar, N Ewen Wang
OBJECTIVE: To assess clinical and nonclinical characteristics associated with the use of pediatric inpatient rehabilitation services among children with traumatic injuries. We hypothesized there would be no nonclinical variations in the use of pediatric inpatient rehabilitation services. STUDY DESIGN: Retrospective analysis of 1139 patients who were injured seriously (0-18 years of age) from our institutional trauma registry (2004-2014). Patients' nonclinical and clinical characteristics were analyzed...
December 8, 2016: Journal of Pediatrics
https://www.readbyqxmd.com/read/27936852/racial-ethnic-disparities-in-the-risk-of-posttraumatic-stress-disorder-symptoms-among-mothers-of-children-diagnosed-with-cancer-and-type-1-diabetes-mellitus
#7
Leilani Greening, Laura Stoppelbein, Kara Cheek
OBJECTIVE: Research findings have indicated that mothers of children diagnosed with life-threatening illnesses can be at risk for posttraumatic stress disorder (PTSD) symptoms (PTSS), with African American mothers being especially vulnerable because of evidence suggesting higher rates of PTSD among both African Americans and women. Race/ethnicity, past trauma exposure and the interaction of these variables were evaluated as risk factors for PTSS, depression, and state and trait anxiety among African American and Caucasian mothers of chronically ill children...
December 12, 2016: Psychological Trauma: Theory, Research, Practice and Policy
https://www.readbyqxmd.com/read/27893241/ill-or-injured-shifting-the-emphasis-to-trauma-in-mental-health-diagnosis-and-treatment
#8
Matthew S Costanzo
TOPIC: This contribution examines the disparity that exists between research that identifies the prevalence of trauma among mental health service users and the low frequency of adequately diagnosing and treating trauma in practice. For this author, the important question to pose is "Could behavioral health services be persistently erring in both diagnoses and treatment approaches to adequately assist and support service users?" PURPOSE: The author proposes an alternative service model which is aligned with the prevalence of complex trauma...
December 2016: Psychiatric Rehabilitation Journal
https://www.readbyqxmd.com/read/27869461/race-differences-in-depression-vulnerability-following-hurricane-katrina
#9
Jeanelle S Ali, Amy S Farrell, Adam C Alexander, David R Forde, Michelle Stockton, Kenneth D Ward
Objective: This study investigated whether racial disparities in depression were present after Hurricane Katrina. Method: Data were gathered from 932 New Orleans residents who were present when Hurricane Katrina struck, and who returned to New Orleans the following year. Multiple logistic regression models evaluated racial differences in screening positive for depression (a score ≥16 on the Center for Epidemiologic Studies Depression Scale), and explored whether differential vulnerability (prehurricane physical and mental health functioning and education level), differential exposure to hurricane-related stressors, and loss of social support moderated and/or reduced the association of race with depression...
November 21, 2016: Psychological Trauma: Theory, Research, Practice and Policy
https://www.readbyqxmd.com/read/27830939/burden-of-usa-hospital-charges-for-traumatic-brain-injury
#10
Jennifer R Marin, Matthew D Weaver, Rebekah C Mannix
OBJECTIVES: This study sought to estimate charges associated with USA hospital visits for traumatic brain injury (TBI), compare charges from 2006-2010 and evaluate factors associated with higher charges. METHODS: The Nationwide Emergency Department Sample database, 2006-2010, was used to estimate charges for emergency department visits and inpatient hospital stays associated with TBI and trends in charges over time were compared. Multivariable linear regression was used to evaluate factors associated with visit charges...
2017: Brain Injury: [BI]
https://www.readbyqxmd.com/read/27818408/piloting-specialized-mental-health-care-for-rural-women-veterans-using-stair-delivered-via-telehealth-implications-for-reducing-health-disparities
#11
Kathryn J Azevedo, Brandon J Weiss, Katie Webb, Julia Gimeno, Marylène Cloitre
This pilot project implemented a mental health program, STAIR, targeting basic skills in mood management training and social functioning for women veterans with military-related trauma who live in rural areas. We report on outreach and implementation procedures, the women veterans' reactions to the program, and lessons learned.
2016: Journal of Health Care for the Poor and Underserved
https://www.readbyqxmd.com/read/27809859/variation-in-type-and-frequency-of-diagnostic-imaging-during-trauma-care-across-multiple-time-points-by-patient-insurance-type
#12
Nathaniel Bell, Laura Repáraz, William R Fry, R Stephen Smith, Alejandro Luis
BACKGROUND: Research has shown that uninsured patients receive fewer radiographic studies during trauma care, but less is known as to whether differences in care are present among other insurance groups or across different time points during hospitalization. Our objective was to examine the number of radiographic studies administered to a cohort of trauma patients over the entire hospital stay as well as during the first 24-hours of care. METHODS: Patient data were obtained from an American College of Surgeons (ACS) verified Level I Trauma Center between January 1, 2011 and December 31, 2012...
November 3, 2016: BMC Medical Imaging
https://www.readbyqxmd.com/read/27786496/racial-ethnic-differences-in-trauma-exposure-and-mental-health-disorders-in-adolescents
#13
Cristina M López, Arthur R Andrews, Andrea M Chisolm, Michael A de Arellano, Benjamin Saunders, Dean G Kilpatrick
Objective: Research has cited increased prevalence of mood disorders, anxiety disorders, and exposure to interpersonal violence for Hispanics and non-Hispanic Black adolescents, as well as ethnic differences in externalizing behavior (e.g., substance use, delinquency). The current study combined these areas by examining racial/ethnic differences in mental health correlates of trauma exposure. Method: Interviews were conducted to assess polyvictimization, posttraumatic stress disorder (PTSD), major depressive disorder (MDD), substance use, and delinquency in a nationally representative sample of adolescents (N = 3,614; 15...
October 27, 2016: Cultural Diversity & Ethnic Minority Psychology
https://www.readbyqxmd.com/read/27771038/demographic-and-socioeconomic-factors-influencing-disparities-in-prevalence-of-alcohol-related-injury-among-underserved-trauma-patients-in-a-safety-net-hospital
#14
Ikenna C Nweze, Jody C DiGiacomo, Silvia S Shin, Camilla Gupta, Rema Ramakrishnan, Lambros D G Angus
BACKGROUND: Alcohol-related trauma remains high among underserved patients despite ongoing preventive measures. Geographic variability in prevalence of alcohol-related injury has prompted reexamination of this burden across different regions. We sought to elucidate demographic and socioeconomic factors influencing the prevalence of alcohol-related trauma among underserved patients and determine alcohol effects on selected outcomes. METHODS: A retrospective analysis examined whether patients admitted to a suburban trauma center differed according to their blood alcohol concentration (BAC) on admission...
December 2016: Injury
https://www.readbyqxmd.com/read/27765646/relationship-of-childhood-adversity-and-neighborhood-violence-to-a-proinflammatory-phenotype-in-emerging-adult-african-american-men-an-epigenetic-link
#15
Linda Witek Janusek, Dina Tell, Noni Gaylord-Harden, Herbert L Mathews
African American men (AAM) who are exposed to trauma and adversity during their early life are at greater risk for poor health over their lifespan. Exposure to adversity during critical developmental windows may embed an epigenetic signature that alters expression of genes that regulate stress response systems, including those genes that regulate the inflammatory response to stress. Such an epigenetic signature may increase risk for diseases exacerbated by inflammation, and may contribute to health disparity...
February 2017: Brain, Behavior, and Immunity
https://www.readbyqxmd.com/read/27760245/implications-of-the-patient-protection-and-affordable-care-act-on-insurance-coverage-and-rehabilitation-use-among-young-adult-trauma-patients
#16
Cheryl K Zogg, Fernando Payró Chew, John W Scott, Lindsey L Wolf, Thomas C Tsai, Peter Najjar, Olubode A Olufajo, Eric B Schneider, Elliott R Haut, Adil H Haider, Joseph K Canner
Importance: Trauma is the leading cause of death and disability among young adults, who are also among the most likely to be uninsured. Efforts to increase insurance coverage, including passage of the Patient Protection and Affordable Care Act (ACA), were intended to improve access to care and promote improvements in outcomes. However, despite reported gains in coverage, the ACA's success in promoting use of high-quality care and enacting changes in clinical end points remains unclear...
December 21, 2016: JAMA Surgery
https://www.readbyqxmd.com/read/27756739/defining-the-fracture-population-in-a-pragmatic-multicentre-randomised-controlled-trial-profher-and-the-neer-classification-of-proximal-humeral-fractures
#17
H H G Handoll, S D Brealey, L Jefferson, A Keding, A J Brooksbank, A J Johnstone, J J Candal-Couto, A Rangan
OBJECTIVES: Accurate characterisation of fractures is essential in fracture management trials. However, this is often hampered by poor inter-observer agreement. This article describes the practicalities of defining the fracture population, based on the Neer classification, within a pragmatic multicentre randomised controlled trial in which surgical treatment was compared with non-surgical treatment in adults with displaced fractures of the proximal humerus involving the surgical neck...
October 2016: Bone & Joint Research
https://www.readbyqxmd.com/read/27756238/world-wide-variation-in-incidence-of-acinetobacter-associated-ventilator-associated-pneumonia-a-meta-regression
#18
James C Hurley
BACKGROUND: Acinetobacter species such as Acinetobacter baumanii are of increasing concern in association with ventilator associated pneumonia (VAP). In the ICU, Acinetobacter infections are known to be subject to seasonal variation but the extent of geographic variation is unclear. The objective here is to define the extent and possible reasons for geographic variation for Acinetobacter associated VAP whether or not these isolates are reported as Acinetobacter baumanii. METHODS: A meta-regression model of VAP associated Acinetobacter incidence within the published literature was undertaken using random effects methods...
October 18, 2016: BMC Infectious Diseases
https://www.readbyqxmd.com/read/27755396/tnf%C3%AE-variation-during-the-menstrual-cycle-and-thereafter-a-new-explanation-for-gender-based-disparities-in-icu-admission-rates-trauma-outcomes-and-general-mortality
#19
Katalin Gornicsar, Tibor Mózes, Andor Grosz, Edit Bíró, Szabolcs Ládi, Paul Clayton
BACKGROUND: Multiple studies have found gender-based disparities in ICU admission rates and in complications following trauma. Female gender was associated with lower mortality when comparing patients less than 50 years of age. These data suggest an important role for cycle rather than gender itself. Our previous results indicate a crucial role for tumor necrosis factor alpha (TNFα) in inducing nososocomial infections. HYPOTHESIS: Cycle is important for TNF and other female hormone productions...
October 12, 2016: Shock
https://www.readbyqxmd.com/read/27749765/trauma-induced-acute-x-chromosome-skewing-in-white-blood-cells-represents-an-immuno-modulatory-mechanism-unique-to-females-and-a-likely-contributor-to-sex-based-outcome-differences
#20
Geber Pena, Christina Michalski, Yong Qin, Robert Donnelly, Ziad Sifri, Anne Mosenthal, David Livingston, Zoltan Spolarics
Sex-related outcome disparities following severe trauma have been demonstrated in human and animal studies however sex hormone status could not fully account for the differences. This study tested whether X-linked cellular mosaicism, which is unique to females, could represent a genetically based mechanism contributing to sex-related immuno-modulation following trauma. Serial blood samples collected for routine laboratory tests were analyzed for ChrX inactivation (XCI) ratios in white blood cells. 39 severely injured (mean ISS 19) female trauma patients on mixed racial and ethnic background were tested for initial (baseline) and trauma-induced changes in XCI-ratios and their associations with severity of injury and clinical outcome...
September 29, 2016: Shock
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